The BC Coroners Service has released its report into the death of 16-year-old Courtenay resident Sara Manitoski, who died last year while camping on Hornby Island.

Coroner Courtney Cote has concluded that Manitoski died of toxic shock syndrome (TSS).

The toxicology exam completed was negative for alcohol, prescription and illicit drugs.

Manitoski, a Grade 11 student in G.P. Vanier’s integrated studies outdoor education (Explore) program, was with fellow students on an overnight field trip at the Outdoor Education Centre in Tribune Bay Provincial Park.

According to the coroner’s report, Manitoski had complained during the day’s activities on March 14, of feeling unwell and suffering from cramps.

She retired to her shared cabin at approximately 9:50 p.m.

At approximately 7 a.m. March 15, the other students in the cabin went for breakfast. They returned at 7:30 to find Manitoski’s alarm sounding.

“Sara failed to shut the alarm off, another student checked on her and found her unresponsive,” the report states. “The students alerted the teachers, and emergency services were contacted and bystander cardiopulmonary resuscitation (CPR) was initiated by the teachers. BC Ambulance Service personnel and RCMP attended. Paramedics took over CPR; however, were unable to re-establish vital signs and resuscitation was discontinued.”

The report said Manitoski was “heard breathing rapidly and shallowly in the middle of the night for a short period of time and then stopped.”

The original examination found increased skin redness on the neck, upper arms, upper chest, lower abdomen and medial thighs.

Tests completed on a tampon found in place identified the presence of staphylococcus aureus. Both findings are consistent with toxic shock syndrome.

“The risk for toxic shock syndrome is increased with tampon use; however, tampon use is not the sole cause. Therefore, it is not possible to definitively exclude the tampon as causative,” said Cote in her report.

“[These] findings, as well as the symptoms Sara exhibited immediately prior to her death, are all consistent with the effects of toxic shock syndrome. I find that Sara Marie Manitoski died on Hornby Island on March 15, 2017, of toxic shock syndrome as a consequence of staphylococcus aureus. I classify this death as natural.”